Editorial | Huge step toward better health

May 12, 2013

The joy was nearly palpable Thursday as Gov. Steve Beshear stepped forward to make his long-awaited announcement that Kentucky indeed will accept the expansion of Medicaid offered through the Affordable Care Act.

The room at the Capitol was packed with health care advocates, hospital officials and representatives of non-profit organizations who have dedicated their lives to working on behalf of the sick, poor, elderly and disabled citizens. They erupted in sustained applause as the governor correctly described it as an historic moment for Kentucky.

“For the first time ever, we are making affordable health care coverage available to every citizen in the Commonwealth,” Gov. Beshear said, drawing more cheers and applause.

These folks have reason to celebrate that Kentucky will accept the Medicaid expansion offered under health care reform, or as critics like to call it, Obamacare. Working in the trenches, they know too well the cruel hardships suffered by Kentuckians with no access to health care in a state with high rates of poverty, some of the nation’s highest rates of disease — and about 650,000 people with no health coverage.

“We are ecstatic,” said Regan Hunt, executive director of Kentucky Voices for Health, a coalition of health organizations across Kentucky.

Now Cabinet for Health and Family Services Secretary Audrey Tayse Haynes and those advocates must ensure the expansion enjoys a successful launch. Detractors, chiefly Republicans, will continue trying to tear it down for purely partisan purposes because it is a key accomplishment of the Obama administration.

But unlike such antagonists, including Kentucky’s Sen. Mitch McConnell, the leader of Senate Republicans, a virtual army of advocates and experts in Kentucky stand ready to make health care reform work because they understand the desperate need of so many.

They know well the suffering of low-wage workers with no health coverage, older citizens who’ve lost jobs and health benefits, the bills that haunt people forced to seek care for a serious illness but with no way to pay.

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Gov. Beshear laid out a compelling case that the expansion — fully funded at 100 percent by the federal government for the first three years — will be an economic boon for Kentucky, creating health care jobs and providing payment for services that hospitals, doctors and other health providers would have to write off as losses.

But most of all, he said, it will offer Kentucky citizens a chance at improved health — giving children a better chance at succeeding in school, helping create a stronger and healthier workforce and a chance to reverse the state’s high rates of obesity, heart disease, diabetes, cancer and the many other illnesses that Kentuckians suffer at disproportionate rates.

Under the expansion, which takes effect in 2014, about 308,000 Kentuckians will become eligible for Medicaid under the Affordable Care Act, which changes the government health plan from one that serves only the very poor and disabled to one based on income. The expansion allows anyone at or below 138 percent of the federal poverty level to sign up.

That would make a single adult earning $15,856 per year, or a family of four, $32,499, eligible for health coverage.

And those above the cut-off for Medicaid but still considered low-income will be eligible for help paying for insurance in the private market through the state Health Benefits Exchange — another feature of health reform — that Gov. Beshear created last year through executive order.

In Jefferson County, some 40,000 people with no health insurance will become eligible under the Medicaid expansion.

Bill Wagner, executive director of Family Health Centers in Louisville, said those community health clinics alone serve about 20,000 people who will become eligible for health coverage under the expansion. The patients will benefit from greater access to care and having a source to pay for the care will make the clinics and physicians networks stronger and more accessible, he told The Courier-Journal.

Gov. Beshear’s administration hired two outside consultants to study the benefits of the expansion and said the conclusion was clear cut.

“The case for it was so overwhelming,” he said. “It just makes sense. We are going to have an opportunity to have every Kentuckian have health insurance. That’s huge. That’s huge.”

It is a huge step forward for Kentucky.

And the health care haters out there might do well to heed the forceful words of the governor.

“Get over it!” Gov. Beshear said. “The Affordable Care Act was passed by Congress, sanctioned by the Supreme Court and is the law of the land.”